Role of staging laparoscopy to evaluate feasibility of performing optimal cytoreductive surgery in epithelial ovarian cancers

Background: The main stay of treatment for epithelial ovarian cancers is surgical cytoreduction. CT scan and staging laparotomy are methods used to assess feasibility to carry out optimal cytoreduction. We evaluated the role of staging laparoscopy in assessing operability for optimal cytoreduction as well as avoidance of unnecessary laparotomies.Methods: Between September 2014-2016, 23 patients of epithelial ovarian cancer underwent staging laparoscopy as part of evaluation method to check feasibility to carry out optimal cytoreductive surgery. The findings were correlated with clinical findings as well as CT scan findings. The impact of laparoscopy to predict operability was studied as well as its use to avoid unnecessary laparotomies.Results: Laparoscopy could correctly evaluate the nature of abdominal mass in 91.3% patients. It picked up omental and peritoneal deposits in 87% and 95.7% patients respectively as compared to 60.9% and 39% picked up on CT scan. More importantly laparoscopy could diagnose mesenteric and small bowel deposits in 34.8% of patients which were never reported on CT scan. The overall impact was reduction in unnecessary laparotomies.Conclusions: Laparoscopic evaluation is a useful adjunct prior to performing a formal laparotomy in epithelial ovarian cancer cytoreductive surgery

A comparative study between 0.5% centbucridine and 2% lignocaine with adrenaline (1:200,000) for bilateral extraction of mandibular premolar using nerve block anesthesia: a double blind randomized controlled clinical study

Background: The purpose of the study was to compare the efficacy of 0.5% centbucridine and 2% lignocaine with adrenaline (1:200,000).Methods: A clinical prospective, controlled, randomized, double blind group study was conducted on 22 patients referred for extraction of mandibular premolars, who were randomly assigned to 2 groups by the split mouth method. Before extraction of mandibular premolar, either 0.5% centbucridine or 2% lignocaine with 1:200,000 adrenaline were used for anesthesia. All the patients were given inferior alveolar, lingual, and long buccal nerve blocks. Pain on injection, onset of anesthesia, duration of anesthesia and changes in blood pressure and pulse rate were monitored and recorded.Results: In our study, statistically significant difference was found between the efficacy of agents as for time for onset of anesthesia, duration of action, and changes in blood pressure and pulse rate, but no statistically significant difference was found for pain on injection between two groups.Conclusions: The efficacy of centbucridine was found to be more as compared to lignocaine with adrenaline, in rapid onset of anesthesia, longer duration of action, and cardiovascular stability. There was no significant difference in the pain on injection for both centbucridine and lignocaine with adrenaline. Centbucridine can be used in medically compromised condition where adrenaline is contraindicated

Ethyl 4′-ethenyl-2′-oxo-4-phenyl-2-(3,4,5-trimethoxy­phen­yl)spiro­[pyrrolidine-3,3′-indoline]-5-carboxyl­ate monohydrate

In the title compound, C31H32N2O6·H2O, the pyrrolidine ring adopts an envelope conformation. The ethyl C atoms of the ethoxy­cabonyl group are disordered over two positions with occupancies of ca 0.80 and 0.20. Intra­molecular N—H⋯O hydrogen bonds form S(5) and S(6) ring motifs. Mol­ecules are linked into a three-dimensional framework by O—H⋯O, N—H⋯O and C—H⋯O hydrogen bonds, and by C—H⋯π inter­actions

Performance Analysis And Experimental Investigation On Exhaust Gas Heat Recovery For IC Engines Using Shell And Tube Heat Exchanger

Increase in energy demand results in shortage of energy. Many effective means were under research to overcome shortage of energy. Recent trend researchers focussing on cogeneration and waste heat recovery in order to improve the efficiency of existing system as well as to avoid energy wastage. In this work waste heat from the exhaust gas is recovered by means of shell and tube heat exchanger to convert cold fluid in to hot fluid. In this system water is used as a working fluid. Water extracts thermal energy to estimate the exhaust heat obtainable from the engine exhaust gases. The exhaust gases which is passed through the tube side of the heat exchanger is obtained from the existing four stroke single cylinder diesel engine whereas water is passed through the shell side of the heat exchanger. The counter flow type heat exchanger arrangement is considered for the analysis. Therefore, the heat transfer characteristics of a system combining compression ignition engine and heat exchanger which recover waste heat from exhaust gas. Performance improvement in this type heat exchanger gives the better USAbility of low grade heat energy.nbs

Cross-institutional Virtual Mock Oral Examination: A New Paradigm?

UNLABELLED: Mock oral examinations (MOEs) are shown to be valuable in preparation for national board oral examinations. Although traditionally conducted in-person, improved technological advances have supported exploring virtual alternatives. Furthermore, the cornoavirus disease 2019 pandemic has necessitated virtual learning. We hypothesized that the virtual platform would improve and expand the MOE experience to include collaborative institutions while approximating a board examination environment. METHODS: Sixteen senior plastic surgery residents and 14 faculty from three separate programs participated in a cross-institutional virtual MOE. Over a single day, each trainee was evaluated by two faculty from a separate institution on six scenarios, including digitally interactive photographs. Immediate postexamination debriefing with feedback was performed. All participants were subsequently invited to complete an anonymous survey regarding MOE experience, accuracy, and stress level, with responses graded on a Likert scale (1-5). RESULTS: Twenty-three participants completed the survey, with 87% having prior MOE experience; however, only 26.1% of participants had virtual MOE experience. Most found the virtual platform more convenient (4.18 CONCLUSIONS: The majority of participants found the virtual MOE experience valuable and comparable to in-person. These results reinforce that a virtual MOE provides an acceptable alternative with greater convenience and improved cross-institutional collaborative efforts

The impact of various safety leadership styles on construction safety climate: A case of South India

The Indian construction industry is the second-largest job-providing sector in the country, which comprises many investments. According to the International Labour Organization (ILO) report, India is a significant contributor to construction site accidents and fatalities among world nations. The poor Safety Leadership (SL) style and the diminished leader\u27s commitment to quality safety outcomes have caused misfortunes in construction sites. This paper aims to identify the impact of various safety leadership styles on the Organisational Safety Climate (OSC) predictors and propose a conceptual model explaining the relationship between SL styles and OSC. The study identifies six leadership styles from the works of literature: Leader-Member Exchange (LMX), Distributed leadership, Contingent reward, Laissez-faire leadership, Management-by-exception, and Superior\u27s empowerment leadership. Structured questionnaires were circulated for data collection among construction professionals working in metropolitan cities in south India. The collected data were analysed using the stepwise regression analysis and Structural Equation Model (SEM) analysis to identify the SL styles influencing OSC predictors. The findings revealed that four out of six SL styles are optimistic. On the other hand, two of them are pessimistic, namely laissez-faire leadership and management-by-exception leadership style, which leads to an increase in construction site misfortunes. The outcome of this study helps the top-level management personnel build and develop a positive safety leadership trait to achieve quality safety outcomes of the construction organization

Inhibition of Notch Signaling in Combination with Paclitaxel Reduces Platinum-Resistant Ovarian Tumor Growth

Introduction: Ovarian cancer (OvCa) is the most lethal gynecologic malignancy in the United States because of chemoresistant recurrent disease. Our objective was to investigate the efficacy of inhibiting the Notch pathway with a γ-secretase inhibitor (GSI) in an OvCa patient-derived xenograft model as a single agent therapy and in combination with standard chemotherapy. Methods: Immunocompromised mice bearing xenografts derived from clinically platinum-sensitive human ovarian serous carcinomas were treated with vehicle, GSI (MRK-003) alone, paclitaxel and carboplatin (P/C) alone, or the combination of GSI and P/C. Mice bearing platinum-resistant xenografts were given GSI with or without paclitaxel. Gene transcript levels of the Notch pathway target Hes1 were analyzed using RT-PCR. Notch1 and Notch3 protein levels were evaluated. The Wilcoxon rank-sum test was used to assess significance between the different treatment groups. Results: Expression of Notch1 and 3 was variable. GSI alone decreased tumor growth in two of three platinum-sensitive ovarian tumors (p < 0.05), as well as in one of three platinum-sensitive tumors (p = 0.04). The combination of GSI and paclitaxel was significantly more effective than GSI alone and paclitaxel alone in all platinum-resistant ovarian tumors (all p < 0.05). The addition of GSI did not alter the effect of P/C in platinum-sensitive tumors. Interestingly, although the response of each tumor to chronic GSI exposure did not correlate with its endogenous level of Notch expression, GSI did negatively affect Notch signaling in an acute setting. Conclusion: Inhibiting the Notch signaling cascade with a GSI reduces primary human xenograft growth in vivo. GSI synergized with conventional cytotoxic chemotherapy only in the platinum-resistant OvCa models with single agent paclitaxel. These findings suggest inhibition of the Notch pathway in concert with taxane therapy may hold promise for treatment of platinum-resistant OvCa

An investigation on the effects of psychological contract (PC) towards site safety in the south Indian construction industry

The construction sector is India\u27s second-largest industry, contributing to the country\u27s economy and providing many job opportunities. However, construction has been described as a hazardous industry with a high rate of injuries, accidents, and fatalities compared to other sectors worldwide. The psychological contract of safety (PCS) is one of the safety climate (SC) variables that influence worker safety behavior (WSB) actions on construction sites to improve safety. This research investigates the influence of SC factors on PCS and PCS on WSB in construction site safety. A quantitative research method has been adopted in this study, and the data is collected from the construction professionals working in South India. Statistical analyses were performed for the collected data; consisted of stepwise regression analysis and structural equation modelling (SEM) analysis to determine the significance of PCS. The findings disclose that in direct effect, four out of six SC factors contribute to enhancing PCS, namely supervisor safety behavior, co-worker safety behavior, worker involvement, and safety system, and it shows that PCS influences WSB. In indirect effect of SC factor on WSB two factors positively influence namely: supervisor safety behavior, co-worker safety behavior and remaining two negatively influences. The outcome of this study helps the construction professionals to improve safety performance by fulfilling their obligations and improving WSB in construction sites

Evaluation of INSeq To Identify Genes Essential for

The reciprocal interaction between rhizosphere bacteria and their plant hosts results in a complex battery of genetic and physiological responses. In this study, we used insertion sequencing (INSeq) to reveal the genetic determinants responsible for the fitness of Pseudomonas aeruginosa PGPR2 during root colonization. We generated a random transposon mutant library of Pseudomonas aeruginosa PGPR2 comprising 39,500 unique insertions and identified genes required for growth in culture and on corn roots. A total of 108 genes were identified as contributing to the fitness of strain PGPR2 on roots. The importance in root colonization of four genes identified in the INSeq screen was verified by constructing deletion mutants in the genes and testing them for the ability to colonize corn roots singly or in competition with the wild type. All four mutants were affected in corn root colonization, displaying 5- to 100-fold reductions in populations in single inoculations, and all were outcompeted by the wild type by almost 100-fold after seven days on corn roots in mixed inoculations of the wild type and mutant. The genes identified in the screen had homology to genes involved in amino acid catabolism, stress adaptation, detoxification, signal transduction, and transport. INSeq technology proved a successful tool to identify fitness factors in P aeruginosa PGPR2 for root colonization

Observing superluminous supernovae and long gamma ray bursts as potential birthplaces of repeating fast radio bursts

Superluminous supernovae (SLSNe) and long gamma ray bursts (LGRBs) have been proposed as progenitors of repeating Fast Radio Bursts (FRBs). In this scenario, bursts originate from the interaction between a young magnetar and its surrounding supernova remnant (SNR). Such a model could explain the repeating, apparently non-Poissonian nature of FRB121102, which appears to display quiescent and active phases. This bursting behaviour is better explained with a Weibull distribution, which includes parametrisation for clustering. We observed 10 SLSNe/LGRBs for 63 hours, looking for repeating FRBs with the Effelsberg-100 m radio telescope, but have not detected any bursts. We scale the burst rate of FRB121102 to an FRB121102-like source inhabiting each of our observed targets, and compare this rate to our upper burst rate limit on a source by source basis. By adopting a fiducial beaming fraction of 0.6, we obtain 99.99\% and 83.4\% probabilities that at least one, and at least half of our observed sources are beamed towards us respectively. One of our SLSN targets, PTF10hgi, is coincident with a persistent radio source, making it a possible analogue to FRB121102. We performed further observations on this source using the Effelsberg-100~m and Parkes-64~m radio telescopes. Assuming that PTF10hgi contains an FRB121102-like source, the probabilities of not detecting any bursts from a Weibull distribution during our observations are 14\% and 16\% for Effelsberg and Parkes respectively. We conclude by showing that a survey of many short observations increases burst detection probability for a source with Weibull distributed bursting activity.Comment: 11 pages, 5 figure